Abe S, Arima S, Nomoto K, Maruyama I, Miyata M, Yamaguchi H, Okino H, Yamashita T, Atsuchi Y, Tahara M
First Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Japan.
Int J Cardiol. 1993 Jan;38(1):33-40. doi: 10.1016/0167-5273(93)90201-q.
We assayed plasma myoglobin and creatine kinase to elucidate the usefulness of rapid assessment of myoglobin for detecting coronary reperfusion in 31 patients with acute myocardial infarction. Reperfusion was achieved in 20 patients by thrombolytic therapy or angioplasty, and it was not in 11 patients. Blood sampling was performed before and 43 +/- 15 (+/- SD) min after the start of treatment. In the reperfused group, blood samples were obtained before and 26 +/- 10 min after reperfusion. Myoglobin was assayed by a new quantitative test based on latex agglutination turbidimetry which required an assay time of 10 min. After treatment, the rate of increase of plasma myoglobin was significantly higher than that of plasma creatine kinase in the reperfused group (9.7 +/- 9.5 and 2.8 +/- 1.6-fold), but not in the occluded group (1.8 +/- 0.6 and 1.5 +/- 0.3-fold). When a 3.0-fold or greater increase in myoglobin (1.9-fold or greater increase in creatine kinase) was taken as evidence of coronary reperfusion, the sensitivity and specificity were 95% and 100% (70% and 82% in creatine kinase), respectively. In conclusion, using the rate of increase of myoglobin, as measured by latex agglutination turbidimetry, coronary reperfusion can be diagnosed within 1 h after reperfusion.
我们检测了31例急性心肌梗死患者的血浆肌红蛋白和肌酸激酶，以阐明快速检测肌红蛋白对判断冠状动脉再灌注的作用。20例患者通过溶栓治疗或血管成形术实现了再灌注，11例患者未实现再灌注。在治疗开始前及开始后43±15（±标准差）分钟采集血样。在再灌注组，分别于再灌注前及再灌注后26±10分钟采集血样。采用基于乳胶凝集比浊法的新型定量检测法检测肌红蛋白，该检测法需时10分钟。治疗后，再灌注组血浆肌红蛋白的升高速率显著高于血浆肌酸激酶（分别为9.7±9.5倍和2.8±1.6倍），而在未再灌注组则无显著差异（分别为1.8±0.6倍和1.5±0.3倍）。当肌红蛋白升高3.0倍或更高（肌酸激酶升高1.9倍或更高）作为冠状动脉再灌注的证据时，其敏感性和特异性分别为95%和100%（肌酸激酶分别为70%和82%）。总之，通过乳胶凝集比浊法测定肌红蛋白升高速率，可在再灌注后1小时内诊断冠状动脉再灌注。
